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General NPI Number Information
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NPI Number | 1902029416
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Entity Type | Organization
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Legal Business Name | NORTH JERSEY OTOLARYNGOLOGY-HEAD AND NECK SURGERY,PA
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1070 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-3619
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Country | US
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Telephone | 973-773-9880
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Fax |
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Provider Business Mailing Address
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Address Line | 1070 CLIFTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07013-3619
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Country | US
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Telephone | 973-773-9880
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. STEPHEN F MATTEL
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Credential | M.D
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Telephone | 973-773-9880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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